Provider Demographics
NPI:1063628568
Name:FOLSOM, ANGELA A (RPH)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:A
Last Name:FOLSOM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 GOSSELIN RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-6145
Mailing Address - Country:US
Mailing Address - Phone:603-644-5639
Mailing Address - Fax:
Practice Address - Street 1:85 STATE ROUTE 101A
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2216
Practice Address - Country:US
Practice Address - Phone:603-672-2021
Practice Address - Fax:603-672-3405
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist